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Medical Students Will Pursue Their Passions under New Stanford Curriculum

Posted on: Wednesday, 10 September 2003, 06:00 CDT

STANFORD, Calif.--(BUSINESS WIRE)--Sept. 10, 2003--Known for its prowess in scientific research, the Stanford School of Medicine launched a different kind of experiment this month by transforming the way in which physicians are trained. The heart of the new curriculum is the "scholarly concentrations" - the equivalent of medical majors in which students will explore an area that excites them. This makes Stanford the only medical school where future physicians develop specialized interests early in their education.

That was part of Stanford's appeal for Steve Ortiz, who now has the first few days of medical school under his belt. "I think this is going to be a great opportunity for us to turn our attention to a specific area of medicine early on, rather than waiting until possibly our residencies to focus on what our future in medicine will be," said Ortiz, who is considering becoming either a cardiothoracic or transplant surgeon who also conducts research. "I was a little concerned that we were the guinea pigs, but so far it seems like a nice fit. Everything here seems very well-planned."

Ortiz and his 86 first-year classmates are the first to participate in the new curriculum, which school officials say is already drawing the attention of other U.S. medical schools. Its key elements include:

-- In-depth study in a scholarly concentration area that will

span the student's years at Stanford.

-- Better integration of the basic science and clinical portions

of the curriculum.

-- Restructuring courses to focus on individual organ systems to

avoid the redundancies that now occur by teaching each

discipline as a separate subject.

-- Reducing weekly classroom instruction to give students more

time for research and academic exploration.

"Stanford is not simply about training physicians or clinicians," said medical school Dean Philip Pizzo, MD, the Carl and Elizabeth Naumann professor of pediatrics and of microbiology and immunology. "That's a really important thing to do and we will continue to do that, but we want to do something more. We want to equip our students with skill sets that will enable them to become leaders who will help to shape the medicine of the future."

Stanford had previously followed the traditional model in which medical students spend their first two years in the classroom learning basic science followed by two years of working with patients in a variety of clinical clerkships. About 70 percent of Stanford students spread their education over five years to include a year of research.

But officials at Stanford and other medical schools recognize that the traditional model doesn't fit the realities of 21st-century medicine. They point out that today's medical students face a world in which knowledge is evolving so rapidly that some elements of their scientific training may be outdated by the time they complete their residencies. Consequently, they will need to re-educate themselves throughout their careers to stay current with the latest discoveries.

Pizzo said a primary goal of the new Stanford curriculum is to prepare students to continue learning throughout their careers and to feel at home in the world of basic science. In addition to the science coursework during the first two years of the curriculum, students will get refreshers on basic science topics during the latter two years of medical school. The clinical portion of the curriculum is also being enhanced; students will work on developing their clinical skills each week of the first two years and will work with patients experiencing the disorders being studied in the classroom.

Courses will be integrated around organ systems to ensure that information is delivered in a more efficient, meaningful way. These efficiencies, along with adding three weeks to the fall quarter, will make it possible to reduce weekly classroom instruction time without sacrificing content, school officials say.

How each student spends those open hours will likely be driven by the scholarly concentrations - the aspect of the curriculum generating the most enthusiasm among students and faculty members. The concentrations are similar in function to the majors used in undergraduate education. Students will be expected to devote at least 200 hours of work to a project in the concentration area they select. They can choose whether to spend a year on original research or to use available information to investigate a question they develop.

"Through the scholarly concentrations our students will have the opportunity to do something unique and interesting that they're passionate about," said Julie Parsonnet, MD, senior associate dean for medical education and associate professor of medicine (infectious diseases). "As our students choose their projects, we want them to look at the role of physicians in the community and learn how to become advocates for individuals and for biomedical science."

The initial eight scholarly concentration areas are biomedical ethics and humanities; bioengineering; biomedical informatics; immunology; public service and community medicine; women's health; health services and policy research; and molecular and genetic medicine. Five other areas - international health, imaging, infectious disease, cardiovascular medicine and clinical investigation - are being developed, Parsonnet said.

Ortiz, who has several months before he needs to select a concentration area, is already intrigued by the immunology track and is planning to spread his education over five years to incorporate a year of research. Ortiz, who earned his undergraduate degree in neurobiology at UC-Irvine, said his classmates are looking forward to their training under the new curriculum. "Everybody seems to be happy that we're here under the new system," he said. "I am excited that we'll be exposed to aspects of clinical medicine earlier than in previous years and that there will be more correlations between the clinical medicine and the basic sciences."

Stanford University Medical Center integrates research, medical education and patient care at its three institutions -- Stanford University School of Medicine, Stanford Hospital & Clinics and Lucile Packard Children's Hospital at Stanford. For more information, please visit the Web site of the medical center's Office of Communication & Public Affairs at http://mednews.stanford.edu.

Quotes about the new curriculum at Stanford's School of Medicine:

Ted Sectish, MD, assistant professor of pediatrics and chair of the school's Committee on Courses and Curriculum: "We're raising the bar on expectations for involvement in meaningful scholarship. Under the new curriculum, every student will graduate with an area of expertise. The changes will make Stanford even more renowned. It will produce doctors who are multifaceted, engage in reflective thinking, and will be more likely to evaluate information from the literature and apply it to daily patient care. This will shorten the time between discovery and delivering new treatment to patients."

Al Taira, fourth-year medical student at Stanford and a member of the Committee on Courses and Curriculum: "A lot of the current students are saying they wish they had the opportunities that will be available through the new curriculum. Most medical students already have interests, such as community service, when they come here. A lot of students feel as if they'll have to give up those interests while they're in medical school. Stanford is telling them that not only should they not give up their interest, but that the school wants them to get really good at it through the scholarly concentrations. The advantage of the concentrations is that you'll be with a small group of people who share your interests. The students will also be able to draw on the full resources of the university, not just the medical school."

Oscar Salvatierra, MD, professor of surgery (transplantation) and of pediatrics, and chair of the school's Faculty Senate: "The new curriculum will form the habits, manners and language of the medical students. It's like with a baby - what you learn early on will be part of your life and your career. The use of basic science will become an integral part of that doctor and an integral part of medicine and should be an integral part of future medicine. We will have a new physician who will be able to assimilate the knowledge that is continually evolving in medicine, and that will be better for the patient. The new curriculum is the key to advancing an exciting new era of medicine, and the faculty at Stanford support it."

Neil Gesundheit, MD, associate dean for medical education and associate professor of medicine (endocrinology): "Most medical schools give students a solid background so that they can become good clinicians. We're upping the ante. We want to give them the opportunity to become early experts in a field, and we're giving them a broad range of areas to choose from. We have so many strengths at Stanford - both in the medical school and throughout the university - that we feel we're well-positioned to pull this off."

Julie Parsonnet, MD, senior associate dean for medical education and associate professor of medicine (infectious diseases): "The curriculum will be a galvanizing force across the whole campus. It will get graduate students and medical students more intertwined. It will bring graduate students into the clinical areas. The new curriculum will be a bridge to an exciting career in medicine."

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